الفهرس 
Atopic dermatitis
The role of humoral immunity in pathogenesis of ADOnly 14 pages are availabe for public view
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Abstract
AD is an eczematous highly pruritic chronic inflammatory relapsing skin disease. Its presentation varies from an acute eczematous relapsing eruption in early life to a characteristic lichenified dermatitis in older patients. AD often occurs in people with personal or family history of other atopic disease i.e. bronchial asthma, rhinitis and hay fever. AD is a multi factorial disease that results from abnormal epidermal barrier, genetic defects and abnormal immunological responses involving both humoral and cell mediated immunity.
Cutaneous T cell attracting chemokine (CTACK) is a homeostatic CC that is selectively secreted by keratinocytes into the skin under complete homeostatic conditions and becomes fixed to endothelial cells by transcytosis process. It mediates its action by forming a ligand with CCR10 bearing CLA+ memory T cells at the site of inflammation.
The aim of this study was to assess serum CTACK levels in AD patients before and after treatment with NB-UVB and to correlate these levels with clinical severity of the disease before and after treatment.
This study included 15 AD patients, and 10 age- and sex -matched controls. Patients were classified according to their severity into 3 groups, two patients showed mild AD, and eight patients had moderate AD, and five patients suffered from severe AD. All patients were treated with NB-UVB. they were 8 females and 7 males their ages ranged between 3 and 18 years with a mean of 9.4±5.5. Serum CTACK levels were assessed using EIA technique for both patients and controls. The patients’ results were statistically compared with controls and were correlated with disease severity before and after treatment.
We found that serum CTACK levels are significantly elevated in atopic patients before treatment compared to controls. And among AD patients its levels were significantly elevated in severe AD compared to mild and moderate AD patients. We also found that there was a significant decrease in mean levels of serum CTACK in atopic patients after treatment compared to the levels before treatment. There was also a significant improvement in mean values of modified SCORAD index after treatment compared to them before treatment.from the results obtained we suggest that CTACK is a useful marker for assessment of the disease severity and activity.We also suggest that NB-UVB is an effective treatment modality for AD with less side effects than systemic PUVA.
Recommendations:
• Further investigations are needed to assess CTACK levels in AD patients on a larger number of patients with different age groups. Also comparison studies to assess its value as a sole disease marker compared to other disease markers.
• Further studies on larger number of patients with different treatment modalities to compare the effectiveness of NB-UVB compared to other types of treatment.